Gender Minority Research Articles

Not Like Everybody Else but We're the Same: Psychosocial Variables Compared Across Diverse Sexual and Gender Identities.

Sexual and gender minority (SGM) people are underrepresented in psychological research. Part of the underrepresentation of SGM people likely stems from potential participants' unwillingness to join a study, but more concerningly, researchers exclude data from SGM participants. Furthermore, much of SGM research focuses on existing health disparities and risk factors rather than wellness-framed and personality research. To fill in this gap, the current study aims to quantify effect sizes of similarities/differences across a broad range of psychosocial measures. Applying the framework of the Gender Similarities Hypothesis, we compare means, variances, and correlations across 34 psychosocial variables between categories of SGM, gender identity, sexual orientation, relationship status, and monogamy (N = 1743). Data was collected online mainly through paid ads on Instagram. Consistently, we find largely similarities across gender identity, sexual orientation, and relationship structure categories. These results support a general expectation that similarities are more common than differences in normative psychological domains, although clear differences in means and variances exist for specific experiences and outcomes. This work informs the inclusion of diverse identities in basic psychological research and further speaks to the generalizability of past findings to populations historically underrepresented in psychological science.

Conformed to Gender Conformity? Gender Nonconformity Stigma is Buffered by Personal Contact

Research has shown that individuals from sexual and gender minorities are more likely to be stigmatized. Taking the perceiver’s perspective, we conducted two experimental studies to examine gender nonconformity stigma and the conditions under which such stigma is more (or less) likely to emerge. In both studies, participants were asked to read descriptions of targets varying in gender (non)conformity and assigned sex (Study 1; N = 337) or sexual identity (Study 2; N = 406). Results from both studies showed that participants preferred more social distance from gender nonconforming (vs. conforming) targets, tended to dehumanize them (i.e., attributed them more primary and less secondary emotions), and reported less anti-violence behavioral intentions and justifications. In both studies, results further showed that having more frequent and positive personal contact with gender nonconforming individuals helps buffer against gender nonconformity bias. Unexpectedly, results from Study 2 showed that humanizing gender nonconforming targets (rather than dehumanizing them) was associated with more violence predispositions for participants who reported having more negative personal contact with gender nonconforming individuals. No differences were found according to the targets’ assigned sex or sexual identity. Taken together, our findings highlight the need to understand the causes and boundaries of gender nonconformity bias.

Factors Associated with Suicidal Behavior in Adolescents: An Umbrella Review Using the Socio-Ecological Model.

Adolescent suicide is a critical social issue with profound and lasting individual and collective consequences. This umbrella review examines factors associated with adolescent suicidal behavior through the socioecological framework of prevention and seeks to identify gaps in the existing literature. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and included a comprehensive search of the of the Web of Science, Scopus, and Cochrane databases in both English and Spanish, covering the period from 2018 to 2024, using terms related to adolescence and suicidal behavior. Out of 6,138 articles identified, 37 met the quality criteria and were selected for analysis. The studies highlighted individual risk factors such as age, gender, belonging to ethnic or gender minorities, emotional disorders, self-destructive behavior, emotional regulation, and experience of physical or emotional pain. Interpersonal factors such as parental relationships, sexual abuse, social isolation, peer pressure, and loneliness were also found. However, the review revealed a worrying lack of studies on societal and community factors and a paucity of research focusing on protective factors. The study highlights the need to include factors related to the physical and social environments that influence health and behavior in future research, as well as to enhance the resources and strengths of adolescents.

Towards Safer Spaces: An Empirical Investigation of Trainee Psychological Safety Within Academic Medical Centers.

Psychological safety is critical for fostering well-being. Integral to the mission of academic institutions, trainees are among the most vulnerable to negative workplace experiences, calling for a need to understand factors that contribute to psychological safety in this population. Our objective is to empirically explore trainee psychological safety to inform best practices for training environments. A survey was used to capture organizational, interpersonal, and individual factors, as well as demographic information in graduate, postdoctoral, medical, resident, and fellow trainees. Descriptive statistics, multivariate ordinal logistic regression, and dominance analyses were used to understand psychological safety and the predictors that explained the majority of the variance in its statistical model. Gender minorities and those who suppressed their race information were less likely to feel psychologically safe. Psychological safety was predominately explained by senses of belonging, recognition, and respect. Notably, trust and confidence in supervisor emerged as a pivotal factor influencing belonging and respect, whereas organizational support played a crucial role in fostering recognition and belonging. Intriguingly, clarity in role expectations and autonomy were positively correlated with recognition. Our findings highlight the interplay between organizational, interpersonal, and individual dynamics shaping psychological safety. Importantly, those who suppress their race as well as female or gender minorities are disproportionally prone to feeling unsafe. We further elucidate role clarity and autonomy as important factors in achieving a sense of recognition. We suggest programs prioritize development beyond technical competencies, recognizing trainees as key stakeholders in the cultivation of positive culture within academic environments.

Exploring the Dimensions and Correlates of Teen Economic Abuse Through a Cross-Sectional Survey

PurposeTeen economic abuse (TEA) is an understudied form of adolescent relationship abuse with limited measures available to assess prevalence. The purpose of this article is to assess the underlying dimensions of survey items (developed with youth) to refine measurement of and validate the structures comprising TEA and examine differences in prevalence of TEA perpetration (Prp) and victimization (Vct) by demographic characteristics. MethodsThis cross-sectional, online survey was conducted between July and September 2021. Youth ages 13–19 who read English and reside in the United States were eligible to complete this study. Recruitment occurred through a national violence prevention listserv with an emphasis on reaching organizations serving youth who are unhoused, juvenile justice and child welfare-system involved, identifying as sexual or gender minorities, or from communities of color. Based on exploratory and confirmatory factor analysis, negative binomial regression models were run to assess associations of demographic characteristics, with levels of TEA Vct and Prp. ResultsAdolescents who identify as White reported significantly more types of TEA exposures than their American Indian or Alaskan Native (adjusted incident rate ratios = 1.3; 95% CI = [1.1, 1.4]), Hispanic Latino (1.2 [1.1, 1.4]), and Multiracial peers (2.4 [1.8, 3.1]). Gender diverse adolescents (1.14 [1, 1.3]) and cisgender females (1.08 [1, 1.2]) had significantly more types of TEA exposures than cisgender males. Those with past-year physical or sexual violence in dating relationships reported more types of TEA exposures (4.1 [3.8, 4.4]) than those who had not experienced such violence. Adolescents with exposure to foster care or homelessness had more types of TEA (1.3 [1.2, 1.4]) than those without such experiences. DiscussionHealthcare providers serving youth should be aware of how economic abuse manifests in adolescent relationships when providing support and resources for youth, especially those who are system-involved or experiencing housing instability. Findings also highlight the need for education about TEA and economic justice in violence prevention programs.

Legal protections for sexual and gender minority youth in foster care: A review of Preventing Sex Trafficking and Strengthening Families Act (Normalcy Standards)

The aim of this study was to investigate legal protections for sexual and gender minority (SGM) youth population who identify as lesbian, gay, bisexual, transgender, queer, intersex (LGBTQ+), or any nonheterosexual orientation, gender identity, or expression (SOGIE) within the context of the United States (US) publicly administered state child welfare foster care system through federal Public Law 113–183 (Preventing Sex Trafficking and Strengthening Families Act – Prudent Parenting for short). SGM youth are identified in foster care 2.5 times higher than their heterosexual peers and often report worse outcomes. There are some federal recommendations for SGM youth, but it does not include normalcy or other activities that are federally supported. A state-by-state analysis of legislation, policy, implementation policy and youth bill of rights was conducted. While there was significant variance across the USA, many states provided levels of support in their legislation, policy implementation and youth bill of rights that could assist SGM youth impact normalcy efforts. More research is needed to investigate if SGM youth in foster care experience protections in the states that have legal protections.

Suicidal behaviors questionnaire-revised: Adaptation and psychometric properties of the Brazilian version

Suicidal behaviors are a significant concern in Latin American countries. However, validated scales in Brazil do not address all behaviors on the suicide spectrum. We aimed to adapt the Suicidal Behaviors Questionnaire-Revised (SBQ-R) for Brazil. The SBQ-R was independently translated, back-translated, and evaluated by experts—two thousand eight hundred ninety-eight participants (68.30% women; M = 27.42; A = 18–69) from Brazil. The SBQ-R items presented adequate reliability (ω = .86). Confirmatory factor analysis (CFA) confirmed the construct validity (χ2(df) = 52.707(2), p<.001; CFI = .997; TLI = .992; RMSEA = .052; SRMR = .024). Multigroup CFA indicated that the SBQ-R is invariant for gender, sexual orientation, race, and education level. The SBQ-R has convergent validity for depression (r = 0.61), anxiety (r = 0.49), stress (r = 0.49), impulsivity (r = 0.40), hopelessness (r = 0.60) and divergent validity, with gender and sexual minorities showing higher levels of suicidal behaviors. The Brazilian SBQ-R is designated for use by Brazilian adults. Future studies must investigate the predictive validity of the SBQ-R in clinical samples.

Are masculine faces “natural” for all men?: an experimental study about predictors of Chinese young adults’ attitudes towards trans men

ABSTRACT Researchers have increasingly paid attention to prejudice against trans people and its predictors. However, few studies have explored if potential predictors may interact to affect people’s attitudes towards trans people. In this experimental study, we examined the impacts of participant-related factors (i.e. gender and prior contact experience with gender or sexual minorities), target-related variables (i.e. gender identity and facial appearance), and their interactions on Chinese young adults’ attitudes towards trans men. We recruited 172 Chinese young adults to rate images of men with different gender identity labels (i.e. cisgender or trans men) and facial appearances (i.e. feminine or masculine). Results showed that a three-way interaction existed among targets’ gender identity labels, targets’ facial appearances, and participants’ genders. Overall, female participants were less likely than men to show more negative attitudes towards trans men than cisgender men. Participants showed more positive attitudes towards masculine-appearing trans men than feminine trans men. The current findings implied that people favoured trans men’s masculine faces, which match the roles of their gender identities.

Not just growth, but worldmaking: A phenomenological exploration of posttraumatic growth among sexual minority women and nonbinary individuals.

Despite experiencing disproportionately high rates of trauma exposure and traumatic stress, sexual and gender minority populations are underrepresented in research on posttraumatic growth (PTG). Data from two waves of semistructured life review phenomenological interviews with 14 sexual minority women and nonbinary individuals were analyzed to explore sexual minority women and nonbinary individuals' lived experiences of growth and healing from exposure to traumatic events. Three main themes were identified: (1) healing through interpersonal connection; (2) new learning about the self and relationships; and (3) healing as political. The first theme describes the central role of interpersonal connection; whereas some participants described seeking and receiving social support from others, most discussed the value of healing with others. The second theme characterizes new learning following trauma, such as learning that, in healthy and safe relationships, one can be loved for who they are. The third theme encompasses how participants politicized their PTG and that even the process of politicizing the traumatic experience itself facilitated growth, as participants understood their struggle as connected to larger systems of oppression, contributing to further identity development. Our findings suggest that sexual minority women and nonbinary individuals experience PTG as a political, iteratively individual and relational process of queer worldmaking (Berlant & Warner, 1998). (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Health disparities in cirrhosis care and liver transplantation.

Morbidity and mortality from cirrhosis are substantial and increasing. Health disparities in cirrhosis and liver transplantation are reflective of inequities along the entire spectrum of chronic liver disease care, from screening and diagnosis to prevention and treatment of liver-related complications. The key populations experiencing disparities in health status and healthcare delivery include racial and ethnic minority groups, sexual and gender minorities, people of lower socioeconomic status and underserved rural communities. These disparities lead to delayed diagnosis of chronic liver disease and complications of cirrhosis (for example, hepatocellular carcinoma), to differences in treatment of chronic liver disease and its complications, and ultimately to unequal access to transplantation for those with end-stage liver disease. Calling out these disparities is only the first step towards implementing solutions that can improve health equity and clinical outcomes for everyone. Multi-level interventions along the care continuum for chronic liver disease are needed to mitigate these disparities and provide equitable access to care.

Risk factors for suicide attempt among adolescents reporting suicidal ideation by sexual and gender minority status: Evidence from the 2022 Minnesota Student Survey.

Suicide is a leading cause of death among adolescents, yet most adolescents who report suicidal ideation do not attempt nor die by suicide. To prevent injury and death, it is thus vital to explore factors potentiating the transition from suicidal ideation to suicidal attempt, especially in high-risk groups like sexual and gender minority (SGM) adolescents. Guided by an "ideation-to-action" framework, we explored risk factors for suicide attempt (ie, "painful and provocative experiences") among adolescents reporting suicidal ideation by SGM status. Data were drawn from the cross-sectional 2022 Minnesota Student Survey and restricted to 10 561 adolescents reporting past-year suicidal ideation (52.3% SGM; 47.7% non-SGM). Analyses first assessed prevalence of exposure to painful and provocative experiences (ie, non-suicidal self-injury, adverse childhood experiences, bullying) by SGM status. Then, in multivariable logistic regression models, analyses probed associations between these risk factors and past-year suicide attempt. Among adolescents reporting recent suicidal ideation, a higher proportion of SGM adolescents reported past-year suicide attempt than non-SGM adolescents (26.7% vs 21.6%, respectively). All examined painful and provocative experiences were more commonly reported among SGM adolescents. In analyses restricted to SGM adolescents, non-suicidal self-injury, sexual abuse by a family member, and bullying demonstrated the largest effect sizes of associations with suicide attempt. Guided by an "ideation-to-action" framework, this research identifies risk factors potentiating suicide attempt in SGM adolescents reporting recent suicidal ideation. Structural and clinical interventions focused on mitigating exposure to painful and provocative experiences may help to prevent suicide among SGM adolescents.

Bias-Motivated Physical or Verbal Violence Among Men Who Have Sex with Men: Findings from the Lisbon Cohort of MSM

Abstract Introduction Victimization based on sexual orientation or gender identity is a cause for concern. Bias-motivated violence affect not only the individuals targeted but also their communities and societies as a whole. Objective To estimate the proportion of bias-motivated victimization among cisgender men who have sex with men (MSM) and to compare sociodemographic and behavioral characteristics and HIV and syphilis test results between victims and non-victims. Methods We used data from the baseline visit of 2811 adult cisgender MSM from July 2017 to December 2020 in the Lisbon Cohort of MSM. Victimization was defined as self-reported lifetime or recent (in the previous 12 months) experience of physical or verbal violence motivated by sexual orientation or gender identity. Rapid HIV and syphilis tests determined serostatus. We conducted descriptive statistics to summarize the sociodemographic and behavioral characteristics and the prevalence of victimization and compared groups using the Student t-test or Mann–Whitney U test and chi-square test, as appropriate. Results Overall, 40.3% of participants reported lifetime bias-motivated physical or verbal violence, and 11.7% reported recent victimization. Recent victimization contexts more frequently reported were street/neighborhood (67.9%) and workplace/school (35.5%). Victimization was associated with younger age (mean age: 26.5 vs 30.2, p-value &lt; 0.001), being born in Brazil or other American countries, or being 14 or younger at their anal intercourse with a man debut (19.5% vs. 11.0%, p-value &lt; 0.001). Lifetime victimization was not significantly associated with reactive results for HIV (p-value = 0.135) or syphilis (p-value = 0.760). Conclusion The violence motivated by sexual orientation or gender identity was quite frequent in this community. The occurrence of violence based on sexual orientation or gender identity in the Lisbon Cohort of MSM was associated with adverse social conditions and health risk behaviors. Policy Implications Raising awareness about bias-motivated violence as a hate crime may deter potential aggressions. Primary violence prevention should tackle specificities of sexual and gender minorities.

Menstrual management in transgender and gender diverse individuals: psychiatric and psychosocial considerations.

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.

11.O. Scientific session: Mental Health Among Sexual and Gender Minority Populations in Diverse Structural Stigma Environments

Abstract Research conducted across numerous countries finds that sexual minority (e.g., lesbian, gay, and bisexual [LGB]) and gender minority (e.g., transgender [T]) individuals represent high-risk populations for poor mental health and suicidality. These disparities are believed to be a consequence of a stigmatizing environment and sexual and gender minority individuals’ disproportionate exposure to stigma-based stress compared to cisgender (i.e., non-transgender) heterosexuals. Stigma occurs at multiple levels to compromise LGBT individuals’ health. At the structural level, stigma manifests as unjust laws, policies, and cultural norms that deny, or fail to protect, the equal rights of LGBT individuals. At the interpersonal level, stigma manifests as discrimination in social interactions, social exclusion, and outright victimization. At the individual level, stigma can tax LGBT individuals’ coping resources by requiring costly behavioral strategies such as concealment of one’s LGBT identity. In this workshop, four studies from different regional environment with varying degree of structural stigma will be presented, i.e., the USA, Switzerland, Rwanda, and Kenya. They resent novel findings on the processes and mechanism underlying LGBT populations increased risk of mental health and links between stigma experiences at different levels. Dr. Clark will present a study of how negative news media coverage influence suicidality among LGBT young adults in the USA using intensive longitudinal assessments. Dr. Pfister will present findings from in-depth interviews concerning suicidality with individuals representing a wide variety of sexual and gender minority identities in Switzerland. Dr. van der Star will present a study exploring how structural stigma environments are linked to interpersonal and individuals level stigma experiences in sexual minorities representing different generations of LGBT populations. Dr. Stojanovski will present data from surveys and interviews of LGBT populations in Kenya and Rwanda focusing on experiences of discrimination and mental health. Key messages • Negative media reporting, discrimination, and barriers to health care can influence mental health and suicidality among LGBT individuals. • Identity concealment may represent a mechanism through which sexual minorities navigate structurally stigmatizing climates.

Bridging gaps: A closer look at the health of sexual and gender minorities in Austria

Abstract Austria has long lacked comprehensive data on the health and well-being of sexual and gender minorities (SGMs). The 2022 LGBTIQ+ Health Report addresses this gap by presenting a comprehensive overview of the health status of SGMs in Austria. To contextualize SGM health issues, a review of the literature, health surveys, and action plans across Europe was conducted in the initial project phase. Then a questionnaire was developed in collaboration with an expert group for quantitative data collection. A total of 1,047 individuals participated in the survey; analyses of the quantitative data were enriched by insights from ten qualitative interviews. Detailed findings cover SGMs’ health status and experiences of discrimination as well as access to healthcare and health-promoting factors. Participants rated their health status lower than the average in Austria. A high number reported encountering discrimination in healthcare, especially among intersex and trans participants. While approximately half of the respondents were satisfied with healthcare provision, around 16% expressed dissatisfaction. Finally, a significant proportion of participants reported having foregone healthcare services at least once despite having health issues. Our work underscores the importance of recognizing the diverse needs of distinct groups within the SGM spectrum. It is crucial to avoid oversimplification by grouping them into a single SGM category as this obscures the unique challenges and inequalities faced by each subgroup. The rapid evolution of terms adds complexity to this work. Moreover, attention should be directed towards intersectionality within these groups as some are hard to reach with an online survey. Navigating the seas of public health innovation, our exploration of SGM health in Austria reveals not only the challenges but also the imperative for inclusive and tailored healthcare strategies. Key messages • The 2022 LGBTIQ+ Health Report Austria reveils SGM health realities: lower health status, discrimination, and unmet healthcare needs, urging targeted interventions. • Acknowledging diverse SGM groups and evolving terminologies, our study underscores the need for nuanced, intersectional healthcare approaches.

‘We do not include tests and treatment for those [STI] conditions’: the trouble in navigating access and care for STIs among gay, bisexual men and transgender and other MSM in Kenya and Rwanda

Abstract Background Lesbian, gay, bisexual men, and transgender persons (LGBT) in Kenya and Rwanda have a hard time accessing healthcare, in particular sexual health screening. We used a social norms and values framework to examine determinants of access to healthcare, with specific attention to sexual healthcare. Methods We draw on cross-sectional mixed methods research in Kenya and Rwanda that examined the lived experiences of sexual and gender minorities in access to health services. A cross-sectional quantitative survey in Rwanda (n = 499) and Kenya (n = 1,550) was conducted with LGBT people. We conducted key informant interviews (n = 81), in-depth interviews (n = 48), digital storytelling (n = 3), and focus group discussions (n = 30). We used a mixed-methods thematic and content analysis to integrate quantitative and qualitative findings. Findings Accessibility and quality of care were the main barriers to healthcare services. The results indicate widespread discrimination and stigma toward LGBT people in service provision. Approximately half of the survey participants, 47%, reported challenges accessing health services, and 25% indicated they experienced discrimination in healthcare. Qualitative results link low quality of care to stigma and discrimination. “Mostly at the hospitals, there are times people take too much time discussing who we are instead of giving us the treatment we seek, and send us to mental health to first deal with our sexuality issues since they think it is a ‘sickness.’” (Focus group, Muhanga, Rwanda). Our study highlights challenges in navigating sexual healthcare in government, faith-based, and donor-funded health facilities. Conclusions Access to healthcare services, particularly sexual health screening and prevention, is a growing issue for LGBT people in Kenya and Rwanda. Stigma acts as a significant barrier to high-quality healthcare. Sensitivity training and educational opportunities for healthcare professionals are urgently needed to address stigma.

Disparities in Mental Health and the Social Determinants of Health Among Privately Insured Transgender Patients in the United States

Abstract Objectives The purpose of this study was to examine disparities in mental health and the social determinants of health (SDoH) among privately insured transgender and gender minority (TGM) patients in the United States. Methods Data came from FAIR Health, a repository of private health insurance claims data covering over 150 million individuals in the United States. TGM patients (n = 274,479) were identified with medical claims that included a diagnosis for gender dysphoria or gender identity disorder. A random 5% selection of cisgender patients (n = 7,456,823) was used as a comparison group. We estimated descriptive statistics and used multivariable logistic regression models to compare health outcomes between TGM and cisgender patients. Results TGM patients were more likely to have anxiety (odds ratio [OR]=7.02; 95% confidence interval [CI]=6.94-7.09), depression (OR = 9.27; 95% CI = 9.16-9.37), post-traumatic stress disorder (OR = 9.03; 95% CI = 8.86-9.21), and substance use disorder (OR = 2.93; 95% CI = 2.86-3.00) compared to their cisgender peers. TGM patients were also more likely to have problems with education and literacy (OR = 5.95; 95% CI = 5.64-6.28), employment (OR = 3.67; 95% CI = 3.44-3.92), economic circumstances (OR = 5.74; 95% CI = 5.39-6.12), and social exclusion (OR = 7.35; 95% CI = 6.91-7.81). Compared to TGM patients living in states with transphobic policy environments, TGM patients in states with comprehensive protections from discrimination fared better. Conclusions We found wide disparities in mental health and the SDoH among privately insured TGM. More research is critically needed to better understand the health and social needs of TGM populations. Meanwhile, policymakers should consider enacting policies that would prohibit discrimination against TGM people throughout the SDoH -- or the conditions where we live, learn, work, play, and age. Health care providers should also receive education on the unique health needs of TGM patients to advance health equity.

An Evaluation of Resilience as a Protective Factor for Mental Health Among Sexual and Gender Minority Young People.

Purpose: Sexual and gender minority (SGM) individuals often face minority stressors that negatively affect their mental health, making it important to identify protective factors against the adverse psychological effects of minority stress. We investigated the potential protective effect of trait resilience in SGM individuals assigned female at birth (SGM-AFAB), who are understudied despite being at particularly high risk for mental health problems. Methods: As part of an ongoing longitudinal cohort study, 452 SGM-AFAB young people (age 16-31 years) completed measures of resilience, minority stressors (victimization, microaggressions, internalized heterosexism, and cisgenderism), and mental health (depression, anxiety, suicidal ideation) in 2017-2018. Moderating effects of resilience on associations between the minority stressors and mental health outcomes were tested using regression analyses. Results: Resilience attenuated the positive associations of microaggressions with both depression and anxiety and of internalized cisgenderism with depression (in transgender and gender-diverse participants), suggesting protective effects. Resilience did not moderate any other associations. Conclusion: These findings suggest that resilience serves as a protective factor against depressive and anxiety symptoms following experiences of microaggressions and against depressive symptoms following internalized cisgenderism among diverse SGM-AFAB individuals. These results underscore the importance of identifying factors that bolster resilience and developing intervention strategies aimed at promoting resilience within SGM-AFAB individuals, especially following experiences of microaggressions and internalized cisgenderism.

Smoking Discrimination Moderates the Relationship between Smoking Stigma and Cigarettes Per Day among Sexual and Gender Minority Individuals

Background: Sexual and gender minority (SGM) individuals report rates of tobacco use that range from 19% to 40% compared to roughly 20% of the general population. Higher rates of tobacco use, compounded by stress from discrimination, contribute to lower cessation rates and worse smoking-related outcomes for SGM individuals. Having multiple stigmatized identities, such as identifying as SGM and being a person who uses cigarettes, may further increase smoking, and decrease the likelihood of cessation. Smoking-related stigma is one relatively unexplored factor that may be related to smoking frequency. Objectives: The present study sought to examine how smoking stigma was related to smoking frequency, and how discrmination moderates the relationship between smoking stigma and cigarettes per day. Results: A sample of 399 self-identified SGM individuals (M age = 36.69) was collected via Qualtrics Panels. Participants were primarily White and bisexual. Participants completed a battery of questions, including measures regarding smoking frequency (operationalized in this article as cigarettes per day [CPD]), smoking felt-stigma, smoking self-stigma, and smoking discrimination. Moderation analyses revealed significant interactions of felt- and self-stigma with smoking-related discrimination. For individuals who perceived higher levels of both self- and felt-stigma, experiencing increased smoking discrimination was associated with increased smoking frequency. However, there was no significant interaction with discrimination for individuals who had lower levels of felt- and self-stigma. Results have implications for smoking reduction and cessation. Helping individuals who have higher levels of felt- and self-stigma manage stress related to being stigmatized may motivate individuals to reduce smoking. Ultimately, these findings can play a role in crafting smoking reduction and cessation programs targeted toward SGM communities, particularly individuals who experience high levels of smoking-related stigma.

Gender Nonconformity, Minority Stress, and Psychological Distress Among Sexual Minority Adolescents.

Purpose: Sexual minority adolescents (SMAs) have disproportionate experiences of mental health symptoms during adolescence, and minority stress contributes to mental health inequities among SMAs. Gender nonconformity (GNC) could place SMAs at higher risk for minority stress and subsequent mental health symptoms. The current study was designed to examine associations between GNC, minority stress, and psychological distress among SMAs. Method: SMAs ages 12-17 years (n = 455; mean age = 15.52 years) in the United States completed a cross-sectional online survey from February to July 2022, including measures of GNC, peer victimization, family rejection, negative expectations, negative disclosure experiences, internalized homonegativity, and psychological distress. We conducted path analysis to examine associations between GNC, minority stressors, and psychological distress, including indirect effects of GNC on psychological distress via minority stress. Results: In multivariable path analysis adjusted for demographic characteristics, GNC was associated with higher levels of peer victimization and negative expectations and lower internalized homonegativity among SMAs. Higher levels of peer victimization and negative expectations were associated with higher psychological distress. GNC was indirectly related to higher levels of psychological distress via higher peer victimization. Conclusions: The current study is the first to document associations between GNC and multiple minority stress experiences among SMAs, and GNC was indirectly related to psychological distress among SMAs via peer victimization. Although all SMAs would benefit from interventions designed to reduce peer victimization and increase their capacity to cope with minority stress, such interventions may be particularly beneficial for SMAs who are gender nonconforming.